Accelerated Biological Age as an Early Pregnancy Risk Factor for Preeclampsia.

IF 2.5 4区 医学 Q1 NURSING
Cindy M Anderson, John Lesniak, Shannon L Gillespie, Joyce E Ohm, Joshua J Joseph, Nathan P Helsabeck, Shili Lin
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Abstract

Background: The inability to predict risk in early pregnancy for preeclampsia represents a major limitation in prenatal care.

Objectives: We used machine-learning approaches to identify early pregnancy features that distinguish women who develop preeclampsia from those with normotensive pregnancies, specifically focusing on the influence of maternal biological age.

Methods: Data were analyzed from a prospective cohort of pregnant women living in the upper Midwest (Midwest cohort) and from a cohort using publicly available data from the Prenatal Exposures & Preeclampsia Prevention Project (PEPP3). In both data sets, DNA methylation (DNAm) was quantified from blood samples collected in early pregnancy. Biological aging was estimated using established epigenetic clocks including Hannum, Horvath, and PhenoAge. Maternal data across pregnancy were collected via medical record abstraction. Predictors of preeclampsia were identified using LASSO regression and Random Forest. The potential predictive capacity of the selected features was evaluated by building logistic regression models with leave-one-out cross-validation and reporting performance metrics.

Results: In the Midwest cohort, accelerated biological aging per Hannum's epigenetic clock as well as higher chronological age and higher gestational weight gain were identified as important predictors of preeclampsia. Interestingly, only Hannum's epigenetic clock showed predictive power for preeclampsia. In the PEPP3 cohort, accelerated biological aging, as measured by Hannum's epigenetic clock, and chronological age were also identified as significant predictors of preeclampsia.

Discussion: Among women who developed preeclampsia, accelerated biological aging during early pregnancy may represent a risk biomarker that can be leveraged in clinical care. These findings identify a promising clinical indicator for preeclampsia risk, addressing a critical gap in screening and early diagnosis.

加速生物年龄是先兆子痫的早期妊娠危险因素。
背景:无法预测妊娠早期子痫前期的风险是产前护理的主要限制。目的:我们使用机器学习方法来识别早期妊娠特征,这些特征区分了发生子痫前期的妇女和正常妊娠的妇女,特别关注母亲生物年龄的影响。方法:数据分析来自生活在中西部上游的孕妇前瞻性队列(中西部队列)和来自产前暴露和先兆子痫预防项目(PEPP3)公开数据的队列。在这两组数据中,DNA甲基化(DNAm)都是从妊娠早期收集的血液样本中量化的。利用已建立的表观遗传时钟(包括Hannum, Horvath和PhenoAge)估计生物衰老。通过病历抽象化的方式收集孕妇孕期数据。使用LASSO回归和随机森林确定子痫前期的预测因子。所选特征的潜在预测能力通过建立逻辑回归模型进行评估,该模型具有留一交叉验证和报告性能指标。结果:在中西部队列中,根据汉纳姆表观遗传时钟加速的生物衰老,以及较高的实足年龄和较高的妊娠体重增加被确定为子痫前期的重要预测因素。有趣的是,只有汉纳姆的表观遗传时钟显示出对先兆子痫的预测能力。在PEPP3队列中,加速的生物衰老(由Hannum’s表观遗传时钟测量)和实足年龄也被确定为子痫前期的重要预测因素。讨论:在发生先兆子痫的妇女中,妊娠早期加速的生物衰老可能是一种可用于临床护理的风险生物标志物。这些发现确定了一个有希望的子痫前期风险临床指标,解决了筛查和早期诊断的关键空白。
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来源期刊
Nursing Research
Nursing Research 医学-护理
CiteScore
3.60
自引率
4.00%
发文量
102
审稿时长
6-12 weeks
期刊介绍: Nursing Research is a peer-reviewed journal celebrating over 60 years as the most sought-after nursing resource; it offers more depth, more detail, and more of what today''s nurses demand. Nursing Research covers key issues, including health promotion, human responses to illness, acute care nursing research, symptom management, cost-effectiveness, vulnerable populations, health services, and community-based nursing studies. Each issue highlights the latest research techniques, quantitative and qualitative studies, and new state-of-the-art methodological strategies, including information not yet found in textbooks. Expert commentaries and briefs are also included. In addition to 6 issues per year, Nursing Research from time to time publishes supplemental content not found anywhere else.
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